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Comparative clinical behavior of zirconia versus titanium dental implants: a systematic review and meta-analysis of randomized controlled trials

dc.contributor.authorMorena, Danilo
dc.contributor.authorLeitão-Almeida, Bruno
dc.contributor.authorPereira, Miguel
dc.contributor.authorResende, Rodrigo
dc.contributor.authorFernandes, Juliana Campos Hasse
dc.contributor.authorFernandes, Gustavo Vicentis Oliveira
dc.contributor.authorBorges, Tiago
dc.date.accessioned2024-09-11T16:06:34Z
dc.date.available2024-09-11T16:06:34Z
dc.date.issued2024-07-31
dc.description.abstractObjective: The goal of this systematic review and meta-analysis was to assess whether there were clinically relevant differences in the treatment of edentulous areas comparing zirconia (Zr) and titanium (Ti) dental implants. The null hypothesis is that no differences can be observed in terms of the clinical parameters; the positive hypothesis I is that Zr implants have generally better results compared to Ti implants; and the positive hypothesis II is that Ti implants have a generally superior result than Zr implants. Methods: This review work was registered on the PROSPERO platform, and its development was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The electronic search process was conducted on three databases (PubMed/Scopus/Web of Science), including randomized controlled trials (RCTs) from the past 10 years (up to April 2024). Identified articles were analyzed and included/excluded based on pre-defined selection and exclusion criteria. The quality assessment and risk of bias were evaluated using a Cochrane risk-of-bias assessment tool specifically designed for randomized trials (RoB2). A meta-analysis was conducted to correlate different treatment options based on the described outcomes; a random-effects model was used in the analysis of the variables. The analysis of heterogeneity was conducted by means of Cochran’s Q-test and Higgins’ I2 statistic. Results: Six RCTs were enrolled; 152 patients (90 males and 62 females) and 448 implants (267 Zr and 181 Ti) were included. Dental implant placement involved both the maxillary and mandibular arches. The implant sites showed heterogeneity in receiving Zr and Ti dental implants; in particular, 22 dental implants were placed in the mid-palatal region and 426 dental implants in the alveolar region (255 were in Zr and 171 in Ti). Regarding the success rate, it was better for Zr but with no statistical difference (p > 0.05); bleeding on probing had slight differences between Ti with 0.34% ± 0.42 and Zr with 0.26% ± 0.36 (p > 0.05); plaque score showed 0.46 ± 0.47 for Ti compared to 0.44 ± 0.49 for Zr (p > 0.05); no statistically significant difference was observed for pink esthetic score (PES). Statistically significant results were found for survival rate, which favored Ti implants (77.6%) compared to Zr (70.3%) (p < 0.05), and for marginal bone loss, which showed less loss in Ti implants (0.18 mm ± 0.47) compared to 0.42 mm ± 0.40 in Zr at 12 months (p < 0.001). Conclusions: The present systematic review and meta-analysis identified the positive hypothesis I and rejected the null and positive hypothesis II; it was possible to conclude that Ti dental implants have a better survival rate and less marginal bone loss than Zr dental implants after 1-year follow-up.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.3390/jcm13154488pt_PT
dc.identifier.eid85200914903
dc.identifier.issn2077-0383
dc.identifier.pmid39124755
dc.identifier.urihttp://hdl.handle.net/10400.14/46496
dc.identifier.wos001287841600001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectDental implantspt_PT
dc.subjectTitaniumpt_PT
dc.subjectTitanium implantspt_PT
dc.subjectYttria-stabilized tetragonal zirconiapt_PT
dc.subjectZirconia implantspt_PT
dc.subjectZirconia oxidept_PT
dc.subjectZirconiumpt_PT
dc.titleComparative clinical behavior of zirconia versus titanium dental implants: a systematic review and meta-analysis of randomized controlled trialspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue15pt_PT
oaire.citation.titleJournal of Clinical Medicinept_PT
oaire.citation.volume13pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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